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A pilot study on the effects of adding c-reactive protein (CRP) point-of-care testing in the management of acutely ill children in primary care

A pilot study to assess how many children and parents/guardians would agree to be recruited to a trial involving a minimally invasive blood test. The acceptability of the CRP test will be assessed for a subset of the children included in a nested randomised controlled trial.


Acute illness in children is a common problem in general practice. Antibiotic prescribing rates in children with an acute illness remain high. A study in adults has shown that point-of-care testing is able to decrease antibiotic prescribing rates by >10% in patients with a suggestive lower respiratory tract infection. The blood level of C-reactive protein (CRP) has moderate to good ability to rule out serious infections in children attending emergency departments or out-of-hours services. At present, point-of-care CRP tests are available that could be used in general practice. Results can be produced in minutes and it requires only a finger prick with limited handling of the sample afterwards.

A large randomised trial could assess whether CRP point-of-care testing is able to assist in the early recognition of serious infections and in the improved targeting of antibiotic prescribing in children with an acute illness. However, several factors necessary for the adequate planning of such a study are unknown at present, making a pilot study necessary.


Study Design: Cohort study with a nested randomised controlled trial
Sponsor:  University of Oxford
Ethical Approval:  Ethics Ref: 13/SC/0045
Chief Investigator / Contact Details: Dr Ann Van den Bruel, University of Oxford